BackgroundDuring military aeromedical evacuation (AE) and prolonged field care (PFC), casualties are at increased pressure injury (PI) risk. Operational PI mitigation strategies research is limited. PurposeUsing multiple factors, this study examined Mepilex/LiquiCell effects on PI risk under simulated AE/PFC. MethodsHealthy adults were stratified by body fat (%) and randomized to six groups on three surfaces. Set A: Warrior Evacuation Litter Pad (WELP) with/without Mepilex; Set B: Vacuum Spine Board (VSB) with/without Mepilex; Set C: Talon litter with/without LiquiCell. Two hours supine (loaded) was needed. Outcomes: Sacral skin transcutaneous tissue oxygen (TcPO2), temperature, moisture, interface pressure, interleukin-1α/Total Protein. Findings54 participants. Sets A/B: No Mepilex effects; temperature increased 2.5°C. Set C: No LiquiCell effects. Significant ΔTcPO2 (unloaded-loaded), with 100% impaired perfusion; temperature increased 1.2°C. DiscussionMultiple risk factors for PI mitigating strategies must consider. Talon with increased pressure/impaired perfusion but smaller temperature/moisture changes; WELP/VSB with increased temperature/moisture but lower pressure/adequate perfusion.